Development and Validation of a Vaginal Anterior Repair Simulation Model for Surgical Training

Abstract

Objective The aims of this study were to design and to validate a surgical simulation model for vaginal anterior colporrhaphy. Methods Obstetrics and gynecology residents were divided into two groups: “novice” and “advanced.” “Expert” group comprised female pelvic medicine and reconstructive surgery (FPMRS) fellows and faculty. All subjects were recorded performing anterior colporrhaphy using the simulation model. Deidentified, silent videos of recorded performances were evaluated by a blinded reviewer using the Objective Structured Assessment of Technical Skills (OSATS) and a procedure-specific assessment, based on the American Board of Obstetrics and Gynecology milestone evaluation. Analysis of variance was used for statistical comparisons. Results Thirty-seven participants included 13 novices, 18 advanced residents, and six experts. The experts scored significantly higher than both resident groups in each of the domains of the OSATS and the procedure assessment. The mean OSATS score for experts was 32.30 (±6.06) (maximum, 35); novice, 17.15 (±5.84); and advanced, 21.11 (±5.61) (P = 0.001). The experts’ scores for the procedure assessment (maximum, 25) was 23.00 (±3.95); novice, 10.62 (±4.70); and advanced, 14.33 (±4.73) (P < 0.001). The two trainee groups did not differ significantly in their overall performance. Most trainees (29 [94%]) evaluated the model as a useful tool in learning this procedure. Conclusions This low-fidelity model can be constructed easily using common materials. The model cost is $43.92 with reusable components ($11 per use). Higher scores by experts versus trainees confirm construct validity of this model. It may serve as a valuable simulation tool allowing trainees to improve their surgical technique for anterior colporrhaphy.

Beef Tongue Surgical Simulation Model for Posterior Vaginal Repair

“…The American College of Obstetricians and Gynecologists published a surgical curriculum that offers a low-fidelity model made of tights, tube socks, a bony pelvis, and hook-and-loop ties. 21 Most recently, O'Meara et al 16 published a study validating a low-fidelity anterior repair model using tights and batting. Geoffrion et al 22 published a low-fidelity anterior and posterior repair model made of silicone skin mounted on a clamp that demonstrated interrater reliability, internal consistency and face, content, and construct validity.…”

“…3). This design was described previously by O'Meara et al 16 for creation of an anterior repair simulation model. All supplies are readily available at a hardware store.…”

Applied use of biomechanical measurements from human tissues for the development of medical skills trainers: a scoping review

“…The limited haptic fidelity in contemporary trainers is likely because subjective, rather than quantitative, methods have been employed when choosing the synthetic materials when constructing trainers. 8,9 We hypothesize that measuring biomechanical properties of tissues and then matching these properties to the synthetic materials used in the manufacture of the trainers will result in an increase in haptic fidelity. Our overall objective is to design high-fidelity trainers using biomechanical properties that have been directly measured from human tissues.…”

Applied use of biomechanical measurements from human tissues for the development of medical skills trainers: a scoping review protocol

“…A critical component of the problem is that simulators do not replicate the haptic qualities of human tissues to a high degree 11–13 . This could be because some simulations are developed using subjective, rather than quantitative data 14,15 . We theorize that, in order to develop a medical trainer for maximizing educational benefits, the materials chosen need to emulate the mechanical properties of human tissues.…”

“…[11][12][13] This could be because some simulations are developed using subjective, rather than quantitative data. 14,15 We theorize that, in order to develop a medical trainer for maximizing educational benefits, the materials chosen need to emulate the mechanical properties of human tissues. By emulating mechanical properties, trainees will have a better understanding of the required haptic qualities for procedural performances.…”